Revisiting interhemispheric imbalance in chronic stroke: A tDCS study

McCambridge, Alana B.; Stinear, James W.; Byblow, Winston D.

doi:10.1016/j.clinph.2017.10.016

Cited by 52 publications

(46 citation statements)

References 39 publications

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“…In this study, behavioral measures were a secondary outcome and consisted of a motor task that was found to be too challenging for two participants to perform with the paretic hand; future studies should consider a motor behavioral task assessment to allow for inclusion of individuals post-stroke across a wider spectrum of motor impairment levels. All participants in the present study were mild to moderately impaired; however, more severely impaired individuals after stroke could show different responses to PAS ( McCambridge, Stinear, & Byblow, 2017 ). Additionally, we did not report a clinical measure of motor function in response to PAS, which will be a necessary step for demonstrating the therapeutic potential of PAS in stroke rehabilitation.…”

Section: Discussionmentioning

confidence: 77%

Paired associative stimulation modulates corticomotor excitability in chronic stroke: A preliminary investigation

Palmer

Wolf

Borich

2018

RNN

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Background:Paired associative stimulation (PAS) combining repeated pairing of electrical stimulation of a peripheral nerve with transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) can induce neuroplastic adaptations in the human brain and enhance motor learning in neurologically-intact individuals. However, the extent to which PAS is an effective technique for inducing associative plasticity and improving motor function in individuals post-stroke is unclear.Objective:The objective of this pilot study was to investigate the effects of a single session of PAS to modulate corticomotor excitability and motor skill performance in individuals post-stroke.Methods:Seven individuals with chronic stroke completed two separate visits separated by at least one week. We assessed general corticomotor excitability, intracortical network activity and behavioral outcomes prior to and at three time points following PAS and compared these outcomes to those following a sham PAS condition (PASSHAM).Results:Following PAS, we found increased general corticomotor excitability but no significant difference in behavioral measures between PAS conditions. There was a relationship between PAS-induced corticomotor excitability increase and enhanced motor skill performance across post-PAS testing time points.Conclusion:These results provide preliminary evidence for the potential of PAS to increase corticomotor excitability that could favorably impact motor skill performance in chronic individuals post-stroke and are an important first step for future studies investigating the clinical application and behavioral relevance of PAS interventions in post stroke patient populations.

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Section: Discussionmentioning

confidence: 77%

Paired associative stimulation modulates corticomotor excitability in chronic stroke: A preliminary investigation

Palmer

Wolf

Borich

2018

RNN

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“…For example, tDCS had been used in stroke rehabilitation by inhibiting the unaffected hemisphere or facilitating the excitability of the affected hemisphere according to the interhemispheric competition model of the stroke . However, the degree to which asymmetric interhemispheric inhibition impacts on stroke recovery is controversial . There seems to be an appealing and intuitive link between functional lateralization and stimulation effect.…”

Section: Introductionmentioning

confidence: 99%

Neural and Psychological Predictors of Cognitive Enhancement and Impairment from Neurostimulation

et al. 2020

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Modulating the temporoparietal junction (TPJ), especially the right counterpart, shows promises in enhancing social cognitive ability. However, it is ambiguous whether the functional lateralization of TPJ determines people's responsiveness to brain stimulation. Here, this issue is investigated with an individual difference approach. Forty‐five participants attended three sessions of transcranial direct current stimulation (tDCS) experiments and one neuroimaging session. The results support the symmetric mechanism of left and right TPJ stimulation. First, the left and right TPJ stimulation effect are comparable in the group‐level analysis. Second, the individual‐level analysis reveals that a less right‐lateralized TPJ is associated with a higher level of responsiveness. Participants could be classified into positive responders showing cognitive enhancement and negative responders showing cognitive impairment due to stimulation. The positive responders show weaker connectivity between bilateral TPJ and the medial prefrontal cortex, which mediates the prediction of offline responsiveness by the lateralization and the social‐related trait. These findings call for a better characterization and predictive models for whom tDCS should be used for, and highlight the necessity and feasibility of prestimulation screening.

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“…Its results tend to be broader and more intense, whereas inhibitory stimulation tends to generate changes in a smaller number of cortical centers with a lower intensity [17,18]. Some researchers have applied the excitatory stimulation on the usually inhibited unlesioned hemisphere in patients with aphasia or motor impairments due to brain lesion [5,19], and they found similar or more consistent results compared to those obtained by inhibitory stimulation. These studies suggest the possibility that the utility of 2 of 11 the excitatory rTMS on the post-stroke brain could be not restricted to the model of inter-hemispheric imbalance.…”

Section: Introductionmentioning

confidence: 94%

Effects of Excitatory Repetitive Transcranial Magnetic Stimulation of the P3 Point in Chronic Stroke Patients – Case Reports

Silva

Souza²,

Santos

et al. 2018

Preprint

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Objective: to evaluate the effects of excitatory repetitive transcranial magnetic stimulation (rTMS) of the international 10-20 system P3 point (intraparietal sulcus region) in chronic patients with a frontal lesion and parietal sparing due to stroke on the impaired upper (UL) and lower limb (LL) as measured by Fugl-Meyer Assessment (FMA). Methods: three patients (C1: 49.83/2.75, C2: 53.17/3.83, C3: 63.33/3.08 years-old at stroke/ years post-stroke, respectively) received two weeks (five days/ week) of rTMS at 10 Hz of P3. A patient was treated in similar conditions with a sham coil (S1: 56.58/4.33). No complimentary therapy was delivered during the study. Patients were evaluated before, after- and two months post-treatment (A1, A2 and A3, respectively). Results: we found increased scores for LL in motor function subsection for C1 and C3 and in sensory function for C2 by A2 that remained at A3. We also found an increased score for UL motor function for C2 and C3, but the score decreased by A3 for C2. C3 score for UL range of motion increased by A3 compared to A1 and A2. Conclusion: In a variable way, P3 excitatory rTMS increased FMA scores in different upper and lower limb subsections of our three treated patients.

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Revisiting interhemispheric imbalance in chronic stroke: A tDCS study

Abstract: The inter-hemispheric imbalance model of stroke recovery may not apply to patients with more severe impairment.

Cited by 52 publications

References 39 publications

Paired associative stimulation modulates corticomotor excitability in chronic stroke: A preliminary investigation

Paired associative stimulation modulates corticomotor excitability in chronic stroke: A preliminary investigation

Neural and Psychological Predictors of Cognitive Enhancement and Impairment from Neurostimulation

Effects of Excitatory Repetitive Transcranial Magnetic Stimulation of the P3 Point in Chronic Stroke Patients – Case Reports

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Revisiting interhemispheric imbalance in chronic stroke: A tDCS study

Abstract: The inter-hemispheric imbalance model of stroke recovery may not apply to patients with more severe impairment.

Cited by 52 publications

References 39 publications

Paired associative stimulation modulates corticomotor excitability in chronic stroke: A preliminary investigation

Paired associative stimulation modulates corticomotor excitability in chronic stroke: A preliminary investigation

Neural and Psychological Predictors of Cognitive Enhancement and Impairment from Neurostimulation

Effects of Excitatory Repetitive Transcranial Magnetic Stimulation of the P3 Point in Chronic Stroke Patients &ndash; Case Reports

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Effects of Excitatory Repetitive Transcranial Magnetic Stimulation of the P3 Point in Chronic Stroke Patients – Case Reports